‐ Patients with one or more pancreatic cysts (≥ 1 cm)
‐ ≥ 18 years old
‐ Previous 1.5T MRI/MRCP within 2 years of inclusion
‐ Written informed consent

- Exclusion criteria

‐ Clear or likely connection between the cyst and the PD on previous 1.5T MRI/MRCP
‐ Clear imaging, biochemical and/or cytological features of serous/mucinous cystic neoplasms (i.e. honeycomb-like cyst, central scar, large unilocular cyst or Carcinoembryonic antigen (CEA) < 5).
‐ Medical history of chronic pancreatitis
‐ Any contraindication for MRI according to local guidelines

- mec approval received

yes

- multicenter trial

no

- randomised

no

- group

[default]

- Type

[default]

- Studytype

observational

- planned startdate

1-sep-2015

- planned closingdate

1-mei-2015

- Target number of participants

20

- Interventions

Patients who are planned to undergo surveillance with MRI/MRCP will undergo 3.0T MRI/MRCP with contrast (gadovist) instead of 1.5T MRI/MRCP with gadovist. Imaging features of 3.0T MRI/MRCP and previously made 1.5T MRI/MRCP will be compared.

- Primary outcome

Primary endpoint is the number of patients in whom a connection between the pancreatic cyst and PD can be visualized with increased certainty on 3.0T compared with 1.5T MRI/MRCP, evaluated by an experienced radiologist using a 5-point scale:
1: no connection PD
2: unlikely connection PD
3: undetermined connection PD
4: likely connection PD
5: clear connection PD

Rationale: Distinction between the different types of pancreatic cysts is crucial, since some cysts are benign without need for follow-up, whereas others are premalignant and require either surgical resection or surveillance. A key feature of the most common premalignant cyst, the side branch-intraductal papillary mucinous neoplasm (SB-IPMN), is the presence of a connection between the cyst and the pancreatic duct (PD). Current imaging, mostly done with 1.5T MRI/MRCP, is often not capable of visualizing this connection. Recent, small studies have suggested that 3.0T MRI/MRCP can provide superior image quality with improved delineation of the PD, but prospective studies in patients with pancreatic cysts are lacking. We hypothesize that 3.0T MRI/MRCP might be more accurate in visualizing a connection between a pancreatic cyst and the PD than 1.5T MRI/MRCP.

Objective: Primary objective is to compare the diagnostic ability of 3.0T and 1.5T MRI/MRCP in visualizing PD communication of pancreatic cysts. Second objectives are to compare the presence of mural nodules and thickened cyst wall and the amount of artefacts.

Study design: Prospective consecutive cohort of 20 patients.

Study population: Consecutive adult patients of the multidisciplinary pancreatic cyst clinic who are under follow-up for at least one pancreatic cyst in which no clear or likely connection with the PD has been seen on previous 1.5T MRI/MRCP and without classic features of a serous/mucinous cystic neoplasm.

Intervention: 3.0T MRI/MRCP during routine follow up of pancreatic cysts

Main study parameters/endpoints: Primary endpoint is the number of patients in whom a connection between the pancreatic cyst and PD can be visualized with 3.0T, whereas 1.5T MRI/MRCP could not.